Acute cholecystitis with massive upper gastrointestinal bleed: a case report and review of the literature

BMC Gastroenterology
Sundeep S SalujaTushar K Chattopadhyay

Abstract

Cystic artery pseudoaneurysm is a rare complication following cholecystitis. Its presentation with upper gastrointestinal hemorrhage (UGIH) is even rarer. Thirteen patients with cystic artery pseudoaneurysm have been reported in the literature but only 2 of them presented with UGIH alone. We report a 43-year-old woman who developed a cystic artery pseudoaneurysm following an episode of acute cholecystitis. She presented with haematemesis and melaena associated with postural symptoms. Upper gastrointestinal endoscopy revealed a duodenal ulcer with adherent clots in the first part of the duodenum. Ultrasonography detected gallstones and a pseudoaneurysm at the porta hepatis. Selective hepatic angiography showed two small pseudoaneurysms in relation to the cystic artery, which were selectively embolized. However, the patient developed abdominal signs suggestive of gangrene of the gall bladder and underwent an emergency laparotomy. Cholecystectomy with common bile duct exploration along with repair of the duodenal rent, and pyloric exclusion and gastrojejunostomy was done. This case illustrates the occurrence of a rare complication (pseudoaneurysm) following cholecystitis with an unusual presentation (UGIH). Cholecystectomy, ligati...Continue Reading

References

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Citations

May 19, 2009·Cardiovascular and Interventional Radiology·Russell MullenKieran D McBride
May 12, 2010·Cardiovascular and Interventional Radiology·Julian HagueZahir Amin
Sep 29, 2011·Journal of Gastrointestinal Cancer·Manojkumar S NairRomi M Navaratnam
Aug 3, 2010·The British Journal of Radiology·I AhmedS Basit
Jan 1, 2011·Case Reports in Gastrointestinal Medicine·Fabio SansonnaRaffaele Pugliese
Dec 1, 2013·Clinical Journal of Gastroenterology·Satoshi SuzukiAkio Takada
Aug 21, 2015·International Journal of Surgery Case Reports·Sofronis LoizidesKrishna Kumar Singh
Jun 30, 2009·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Shan-Zu LinChun-Chia Chen
Aug 8, 2009·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Philippe GottigniesDavid De Bels
Jan 8, 2014·International Journal of Surgery Case Reports·Michael A GlaysherKaroly Szentpali
Jul 17, 2013·International Journal of Surgery Case Reports·Gael R NanaJames R Ramus
Jan 1, 2010·Journal of Surgical Case Reports·Nkwam Nkwam, Kate Heppenstall
Jun 24, 2017·International Journal of Surgery Case Reports·Claudia TrombatoreAntonio Di Cataldo
Mar 30, 2018·BMJ Case Reports·Matta S KuzmanDhanny Gomez
May 12, 2015·Acute Medicine & Surgery·Takeshi NishimuraJoji Kotani

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